| NPI | 1205140902 |
|---|---|
| Doing Business As | GPHA WOODLAND AVE. BEHAVIORAL HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | D TINA SMITH Provider Enrollment Spec. 215-925-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2017-03-15 |